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Title: Fizioterapevtski pristopi pri zdravljenju sindroma zapestnega prehoda Authors: Završnik, Ana (Author) Omejec, Gregor (Mentor) More about this co-author... Language: Slovenian Work type: Bachelor thesis/paper Tipology: 2.11 - Undergraduate Thesis Organization: FIZIOTERAPEVTIKA - PHYSIOTHERAPEUTICA Abstract: SZP nastane zaradi utesnitve medianega živca v zapestnem prehodu in je najpogostejša nevropatija. Večina pacientov razvije tipično klinično sliko, ki se kaže z mravljinčenjem v prstih rok in bolečinami v zapestju. Vzrok utesnitve medianega živca je prekomerno obremenjevanje zapestja in prstov, ki povzroči vnetje kitnih ovojnic, njihovo zadebelitev in posledično zvišanje pritiska znotraj zapestnega prehoda. Najpogostejše dejavnike tveganja predstavljajo ženski spol, starost od 45 do 54 let, endokrine bolezni (najpogosteje sladkorna in revmatična bolezen) ter ponavljajoči se gibi zapestja in prstov. Pacient s tipičnimi simptomi sprva obišče osebnega zdravnika, ki opravi anamnezo in usmerjen klinični pregled. Ob tipičnih simptomih in znakih lahko za potrditev klinične diagnoze pacienta napoti na nevrofiziološke meritve prevajanja živcev. Zdravljenje je lahko konservativno ali operativno. Konservativno zdravljenje je prva izbira pri blagi in zmerni stopnji okvare. Ob neučinkovitosti konservativnega zdravljenja je indicirano operativno zdravljenje. Pri konservativni obliki zdravljenja se najpogosteje uporabljajo opornice za zapestje in prste, injekcije kortikosteroidov, fizioterapevtske modalitete (ultrazvok, nizkofrekvenčni laser, manulana terapija, mobilizacija živčevja) in jemanje nesteroidnih antirevmatikov. Fizioterapevtski pristopi so učinkoviti kratkoročno in srednjeročno, njihov čas učinka pa se razlikuje. Izmed vseh pristopov izstopajo udarni valovi, saj so pokazali enako učikovitost kot kortikosteroidi. Zato v prihodje pričakujemo njihovo pogostejšo uporabo za zdravljenje SZP. Na podlagi večletnih raziskav pa si avtorji še vedno niso enotni, ali je za zdravljenje SZP učinkovitejša aplikacija terapevtskega UZ ali laserja. Največji učinek pridobimo s kombinacijo terapij. SZP ima velike socialne in ekonomske posledice, zato je pomembno z zdravljenjem pričeti čim prej in z metodo, ki simptome odpravi hitro in dologoročno s čim manjšimi zapleti. Keywords: sindrom zapestnega prehoda, konservativno zdravljenje, fizioterapevtski pristopi. Year of publishing: 2020 COBISS_ID: 42917379  VisID: 2479 Views: 2148 Downloads: 296 Files:  588$$9-11-2020-dn_zavrsnik_koncna_om-sprejeti_(1).pdf (1,43 MB)   Metadata:

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Secondary language

Language:	English
Title:	Physiotherapy approaches for treatment of carpal tunnel syndrome
Abstract:	Median nerve entrapment at the wrist is shown as carpal tunnel syndrome (CTS). It is one of the most common neuropathies. Most of the patients develop a typical clinical picture with tingling and paresthesias in fingers, which is more pronounced during the night and in the morning. The cause of median nerve entrapment is in pronounced manual labor which causes inflammation of tendons flexors sheaths and their thickening, which increases pressure within the carpal tunnel. The most common risk factors are gender (women), age between 45 and 54, endocrine diseases (most commonly diabetes and rheumatic disease), and repetitive movements of wrist and fingers. A patient with symptoms first visits a personal physician who performs a history and clinical examination. Clinical diagnosis of CTS can be confirmed with nerve conduction studies and/or the US. Mild or moderate conservative treatment should be recommended. However, in the cases of conservative treatment inefficiency, surgery should be proposed. Conservative treatment frequently contains splint for wrist and fingers, corticosteroid injections, physiotherapeutic modalities (ultrasound, low level leser, manual therapy, nerve mobilization techniques) and nonsteroidal anti-inflammatory drugs. Physiotherapeutic approaches are effective in the short and medium-term. However, their duration of effect varies. Extracorporeal shockwave therapy stands out among all therapies. Furthermore, they showed the same effectiveness as corticosteroid injections. In the future, we can expect more frequent use for treating CTS. Based on the studies’ results, authors still do not have a uniform opinion about the efficiency of the US and laser therapy in patients with CTS. The greatest effect we get when we combine different therapies. CTS also has social and economic consequences. Because of these reasons, it is important to start treatment as soon as possible to eliminate symptoms quickly and long-term with as few complications as possible.
Keywords:	carpal tunnel syndrome, conservative treatment, physiotherapeutic approaches.

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